By Rafia Jahanzeb
ISLAMABAD, Aug 23 (APP): In a district of nearly 1.8 million people, over half of the women of reproductive age in Mansehra suffer from malnutrition or anemia. In rural towns like Gidarpur and Oghi, the lack of nutrition awareness, limited health services, and poor dietary diversity are quietly affecting generations of women and children.
“Most women here don’t even know what folic acid or vitamins are,” said Zara Bibi from Oghi while talking to APP. “There’s no one to guide us. Because of this, many women suffer from illnesses like anemia and face complications during pregnancy.”
Doctors working in the area say the situation is severe and often overlooked.
“Patients come with Vitamin D and B12 deficiencies, along with iron deficiency,” said Dr. Mehreen Asad from Mansehra speaking to APP. “They report fatigue, bone pain, and constant weakness. Only a proper diet and regular multivitamins can protect women from long-term harm.”
In many parts of Mansehra, conservative cultural norms further restrict women’s access to healthcare. Social taboos discourage women from consulting male doctors, and although female doctors are available, their numbers are limited and mostly concentrated in urban areas. In households where women’s mobility is tightly controlled, they often need permission or accompaniment to visit clinics, which are frequently located far from their homes. When female doctors or midwives are not present nearby, many women delay or avoid seeking care altogether, even when facing serious health issues.
Mansehra’s health challenges are reflected in broader regional data. In Khyber Pakhtunkhwa, nearly 40% of children under five are stunted, and 20% are wasted, according to the 2018 National Nutrition Survey. These signs of chronic and acute malnutrition often go unnoticed in rural households, where basic nutrition and hygiene guidance is limited.
Mansehra is largely rural, with over 1.6 million people living in villages. Access to healthcare is limited, and many women face barriers to getting treatment or nutrition guidance.
Ayesha Khan, from Gidarpur, shared, “We don’t have proper hospitals or multivitamins. We mostly eat wheat or maize. No one here thinks about nutrition because they simply can’t afford more.”
Mothers like Amna Gul in Oghi witness the toll on their children also, saying, “Our kids remain weak because we can’t afford milk or nutritious food, they keep falling sick over and over.”
Children across the district face similar struggles. Poor diet, combined with repeated infections and inadequate vaccination or deworming coverage, keeps them underweight and vulnerable.
Primary health units in rural Mansehra often operate without female doctors or midwives, limiting access for women. Lady Health Workers (LHWs), essential to the rural health system, are often stretched thin and rarely trained in nutrition counseling.
While maternal and child health programs exist under the District Health Office, implementation remains patchy. Vitamin A supplementation and deworming campaigns happen irregularly, and there is no consistent screening for anemia among pregnant women.
Economic hardship also plays a major role. Families often depend on staple foods that provide calories but not enough nutrients. Cultural practices mean women and children usually eat last, and less. Poor sanitation further contributes to repeated illness and malnutrition.
Though Mansehra’s overall literacy rate is higher than the provincial average at around 63%, this masks significant gender differences. Across Khyber Pakhtunkhwa, female literacy is only 37%, compared to the national average of 53%. This gap affects women’s access to health information and their ability to make informed choices for their families.
What needs to be done
To improve health in Mansehra, experts suggest mobile clinics with female staff, nutrition training for health workers, better NGO coordination, community awareness, kitchen gardens, and routine anemia screening, simple steps with powerful impact.
Malnutrition in Mansehra is not just a health issue, it it affects learning, productivity, and long-term well-being. With female literacy slightly over 50% and healthcare services stretched thin, the problem continues quietly in homes, especially in villages and towns across the district.
Poor nutrition among women and children is a crisis that endangers the entire community’s future. If left unaddressed, it will deepen health challenges and threaten long-term stability. This is a wakeup call that demands swift and decisive action.